Individual provider Active NPI

Maddison L Miles, LISWS, LICDC

  • Addiction (Substance Use Disorder) Counselor
  • Fairlawn, OH
National Provider Identifier
1558851691
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LICDC.162841 Issued in OH
Practice address
3094 W Market St Ste 105
Fairlawn, OH 44333-3617
Phone
(440) 260-8300
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2506367 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162841 OH Primary
Community Health Worker 172V00000X I.2506367 OH

Addresses

Primary practice location

3094 W Market St Ste 105
Fairlawn, OH 44333-3617

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Other practice location 1

412 Lincoln Way E
Massillon, OH 44646-8404
Phone (330) 452-9807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

343 W Bagley Rd
Berea, OH 44017-1370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.162841OHMDAddiction (Substance Use Disorder) Counselor
I.2506367OHMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Commquest Services, Inc. Addiction (Substance Use Disorder) Past Accepting new patients
Commquest Services, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1558851691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 W MARKET ST STE 105",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333617",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 Lincoln Way E",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446468404",
            "country_code": "US",
            "telephone_number": "330-452-9807",
            "fax_number": "330-452-9808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES",
        "first_name": "MADDISON",
        "middle_name": "L",
        "credential": "LISWS, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2506367",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162841",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "I.2506367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.